$12.5B
FTC-reported fraud losses in 2024
FTC says consumers reported losing $12.5 billion to fraud in 2024.
Medicaid eligibility check scam
Scammers contact people claiming to verify Medicaid eligibility, collect personal and financial data, and use it to commit identity theft or file fraudulent Medicaid claims.
“Medicare scam”
↑ 71%Key indicators
Estimated impact
$960
median reported loss
Typical range$60 – $6.0K
Recovery rate~15%
Scam breakdown
1
Scammers call during Medicaid redetermination periods, exploiting real confusion as states unwind continuous enrollment
2
They claim the beneficiary will lose coverage unless they immediately provide personal and financial information over the phone
3
Stolen information is used for identity theft and to bill Medicaid for fraudulent services under the victim's name
What to do first
Contact your state Medicaid office directly using the number on your Medicaid card or Medicaid.gov to verify eligibility
Related terms
Medicaid verification scamMedicaid renewal fraudfake Medicaid eligibility checkMedicare and health scamsPhoneRisingPatientsLow-income householdsSeniorsHealthcare workersRetirees and seniorsImmigrants and visa holdersUnited StatesMedicaid verification scamMedicaid renewal fraud
Real-world example
How this scam plays out in practice
Based on reported patterns. Names and details are illustrative.
The setup
Fatima, 35, a patients, encountered what appeared to be a legitimate medicare and health scams situation while using Phone. Scammers call during Medicaid redetermination periods, exploiting real confusion as states unwind continuous enrollment
Step 2
What happened next was calculated: They claim the beneficiary will lose coverage unless they immediately provide personal and financial information over the phone
Step 3
The pressure escalated quickly: Stolen information is used for identity theft and to bill Medicaid for fraudulent services under the victim's name
The outcome
Fatima realized something was wrong when unsolicited call claiming your medicaid is about to expire and you must re-verify immediately. By that point, significant damage had already been done — money sent, personal information shared, or trust exploited.
The lesson
Contact your state Medicaid office directly using the number on your Medicaid card or Medicaid.gov to verify eligibility Fatima's experience shows why unsolicited call claiming your medicaid is about to expire and you must re-verify immediately and caller requests your social security number and bank details to confirm eligibility are the clearest early warning signs.
How to identify it
- Unsolicited call claiming your Medicaid is about to expire and you must re-verify immediately
- Caller requests your Social Security number and bank details to confirm eligibility
- Caller claims to be from your state Medicaid office but uses a generic or unverifiable number
- Pause before paying, clicking, or sharing information. Scammers rely on speed.
- Verify the sender, company, or agency using a phone number or website you already know is legitimate.
- Treat secrecy, urgency, and off-platform payment requests as strong scam signals.
What to do now
- ✓Contact your state Medicaid office directly using the number on your Medicaid card or Medicaid.gov to verify eligibility
- ✓Know that Medicaid offices will send renewal notices by mail — not demand immediate information by phone
- ✓Report Medicaid fraud to your state Medicaid Fraud Control Unit
What to save before reporting
- ✓Save the message, profile, phone number, email, or URL that was used.
- ✓Keep payment confirmations, receipts, and account alerts before you dispute or delete anything.
- ✓Write down the timeline while the details are still fresh.
- ✓Save the full chat or call log before blocking the sender so the reporting path still has the original context.
How big is this problem
You are not alone — this scam affects millions of people.
These numbers come from government agencies and official reports. If you have been affected, know that this is a widespread problem — not something that only happens to careless people.
FTC 2024 fraud losses
Imposters
Most common FTC fraud category in 2024
FTC says imposter scams remained the most commonly reported fraud category in 2024.
History and evolution
- This scam family tends to persist because the social-engineering pressure works even when the exact scripts, platforms, and payment methods change.
- The specific packaging evolves over time, but the core pattern usually stays the same: create urgency, control the channel, and push action before verification.
- State Medicaid agencies reported a surge in eligibility verification scams during the post-pandemic continuous enrollment unwinding period beginning in 2023
Recovery and follow-up
- ✓Save the messages, receipts, account alerts, and transaction details before you block or delete anything.
- ✓Report the scam through the official platform or government channel that best matches where it happened.
- ✓Tell close contacts if a phone or text scam used your identity, so scammers cannot reuse the same story against people around you.
- ✓Contact your state Medicaid office directly using the number on your Medicaid card or Medicaid.gov to verify eligibility
- ✓Know that Medicaid offices will send renewal notices by mail — not demand immediate information by phone
Why this pattern keeps working
Even when the story changes, most scams still use the same pressure pattern: urgency, authority, and a request to move money or data fast.
State Medicaid agencies reported a surge in eligibility verification scams during the post-pandemic continuous enrollment unwinding period beginning in 2023
OpenScam research
Where to report it
If you have been targeted by this scam, reporting it helps authorities track the pattern and protect others. United States has dedicated agencies that handle fraud reports.
ReportFraud.gov
Federal Trade Commission
Central U.S. consumer fraud reporting portal.
File an IC3 complaint
FBI Internet Crime Complaint Center
FBI portal for internet-enabled crime reports.
Start identity theft recovery
IdentityTheft.gov
Official U.S. identity theft recovery plan builder.
Explore further
Understand the bigger picture
Who is most at risk
Who this scam targets
Primary targets
Patients, Low-income households, Seniors
Geographic concentration
United States
Primary channel
Phone — Medicare and health scams
Why this group is vulnerable
Patients are particularly vulnerable because this scam exploits trust in familiar brands, authority figures, and time-sensitive decisions. The growing number of reports suggests that awareness among this demographic remains low.
Sources and methodology
How we verify this information
OpenScam tracks scam patterns using a combination of government consumer protection databases (FTC, IC3, Action Fraud), platform-specific fraud reports, and verified consumer complaint data. Each entry is cross-referenced against at least two independent sources before publication.
Severity ratings are based on financial impact potential, reversibility of damage, and volume of reports across multiple reporting channels. Trend velocity reflects the rate of change in report volume over the most recent 90-day window.
This page was last verified on 2026-04-04. Red flags, recovery steps, and reporting resources are reviewed quarterly against current agency guidance.
Evidence and indicators
- State Medicaid agencies reported a surge in eligibility verification scams during the post-pandemic continuous enrollment unwinding period beginning in 2023
Source notes
- OpenScam research
Frequently asked questions
Common questions about medicaid eligibility check scam
How does the medicaid eligibility check scam work?+
Scammers call during Medicaid redetermination periods, exploiting real confusion as states unwind continuous enrollment They claim the beneficiary will lose coverage unless they immediately provide personal and financial information over the phone Stolen information is used for identity theft and to bill Medicaid for fraudulent services under the victim's name
What are the warning signs of medicaid eligibility check scam?+
Unsolicited call claiming your Medicaid is about to expire and you must re-verify immediately Caller requests your Social Security number and bank details to confirm eligibility Caller claims to be from your state Medicaid office but uses a generic or unverifiable number
What should I do if I encounter medicaid eligibility check scam?+
Contact your state Medicaid office directly using the number on your Medicaid card or Medicaid.gov to verify eligibility Know that Medicaid offices will send renewal notices by mail — not demand immediate information by phone Report Medicaid fraud to your state Medicaid Fraud Control Unit
Who is most at risk for medicaid eligibility check scam?+
This scam primarily targets Patients, Low-income households, Seniors. It is most commonly reported in United States and typically appears on Phone.
Is medicaid eligibility check scam on the rise?+
Medicaid eligibility check scam is currently on the rise with growing reports. It has been reported across US. Last updated 2026-04-04.
Related scams
Similar scams to watch out for
AI impersonation
↑ 34%AI voice clone family emergency scam
A caller sounds exactly like a family member in distress and pressures the victim to send money immediately before verifying the story.
What to do first
Hang up and call the family member back directly using a known number.
Targets
Parents
Seen in
U.S.
AI impersonation
↑ 34%AI school injury parent call scam
A caller with a child's cloned voice says there has been a school injury and demands immediate payment before the parent verifies the story.
What to do first
Call the school or student directly using a known number before taking any action.
Targets
Parents
Seen in
U.S.
AI impersonation
↑ 52%Fake lawyer court date payment call
A caller pretending to be a lawyer uses cloned voices and legal jargon to say you missed a court date and need to pay immediately to avoid arrest.
What to do first
End the call and contact the court through its public website or number.
Targets
Older adults
Seen in
U.S.
Help someone avoid this scam.
Scammers succeed because people do not talk about it. If you or someone you know has been affected, there is no shame in it — it happens to millions of people every year. Share this page with friends and family so they know what to look for.